Amelogenesis imperfecta: therapeutic strategy from primary to permanent dentition across case reports

Abstract

BackgroundHereditary enamel defect diseases are regrouped under the name “Amelogenesis Imperfecta” (AIH). Both dentitions are affected. Clinical expression is heterogeneous and varies between patients. Mutations responsible for this multigene disease may alter various genes and the inheritance can be either autosomal dominant or recessive, or X-linked. Until now, no therapeutic consensus has emerged for this rare disease.Case presentationThe purpose of this article was to report treatments of AIH patients from childhood to early adulthood. Treatment of three patients of 3, 8 16 years old are described. Each therapeutic option was discussed according to patients’ age and type of enamel alteration. Paediatric crowns and resin based bonding must be preferred in primary teeth. In permanent teeth, non-invasive or minimally invasive dentistry should be the first choice in order to follow a therapeutic gradient from the less invasive options to prosthodontic treatments.ConclusionFunctional and aesthetic issues require patients to be treated; this clinical care should be provided as early as possible to enable a harmonious growth of the maxillofacial complex and to prevent pain.

Functional and Esthetic Rehabilitation of a Young Patient with Amelogenesis Imperfecta

“…The cumulated evidence on outcomes of alternative restorations for each type of AI is critically needed [17]. With such evidence, clinicians may then select more favorable approaches to treat individual AI patient and to optimize their patient's oral health and longterm prognosis [18].…”

“…Surprisingly, no increased incidence of caries has been reported. [10] The main sequel to patients with AI is represented by dental sensitivity and breakdown of hard tissues due to weak mechanical properties of affected teeth. Still, there are marked impacts on children and adolescents as a result of AI, including aesthetics, function, and psychosocial aspects.…”

Tratamiento conservador de un adolescente con amelogénesis imperfecta.

“…La evidencia actual disponible con respecto a los enfoques de tratamiento de pacientes con AI es variada pero limitada por su nivel de evidencia (10) , ya que la mayoría son reportes de casos clínicos. Estos enfoques varían dependiendo de varios factores como la edad, estatus socioeconómico, condición periodontal, pérdida de la estructura del diente, gravedad del trastorno y la cooperación del paciente (5) . Un factor negativo a considerar en este caso, fue el bajo nivel socioeconómico familiar, lo que nos impidió realizar Tratamiento conservador de un adolescente con amelogénesis imperfecta.…”

“…El dolor no está asociado con esta AI aunque la sensibilidad térmica algunas veces ha sido reportada (4) . Con respecto al diagnóstico diferencial, esta AI debe ser diferenciada de los defectos de desarrollo del esmalte causados por factores ambientales como por traumatismos, también debe ser diferenciada de la hipoplasia incisivomolar (HIM) (5) , ya que esto podría variar la selección del tratamiento. Los pacientes con AI reportan niveles significativamente más altos de evitación social y angustia que los sujetos sin esta condición; en los adultos, se ha reportado un impacto social en la educación, satisfacción laboral y construcción de la familia (6) .…”

Knowledge, Attitude and Practice Among Dental Students on Amelogenesis Imperfecta

“…Amelogenesis imperfecta is a rare genetic disease affecting enamel.Both primary and permanent teeth are affected (Toupenay et al, 2018).The prevalence varies from 1:700 to 1:14 000, according to the populations studied. clinical features of patients with AI varies according to the type of AI involved.…”